No. When internal hemorrhoids reach stage IV, all the earlier symptoms of itching, burning, pain and prolapse are present. The difference in stage IV over all the earlier stages is that the hemroids can no longer be manipulated back into place in the rectum. Because of this, strangulation is possible, whereby the sphincter muscle of the anus constricts on the protruding hemroid causing pain and even thrombosis. When internal hemroids reach this stage, a doctor’s intervention is required, and treatments like surgery or laser coagulation may be necessary.